Rib-X Pharmaceuticals, Inc., 300 George Street, Suite 301, New Haven, CT 06511, USA.
Future Microbiol. 2011 Feb;6(2):137-41. doi: 10.2217/fmb.10.171.
Evaluation of: Kumarasamy KK, Toleman MA, Walsh TR et al.: Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect. Dis. 10(9), 597-602 (2010). Are bacteria always going to outsmart us? With the emergence of the metallo-β-lactamase bla(NDM-1) gene, it certainly seems so. Whereas at one time bacterial clones resided in hospitals or long-term care facilities, it is now apparent that they have the capability of thriving in the community and quickly spreading across countries and continents with few impediments, thanks to accessible, rapid global travel. Thus, under conditions favoring the organism (promiscuous or inappropriate antibiotic use and poor infection control procedures), what was at one time a local problem can rapidly become a worldwide health crisis. Given that the discovery and development of a new antibiotic can take a decade or more, multiply resistant pathogens can have ample time to wreak havoc before a successful novel agent comes to market. At one time a single drug, penicillin, was enough to raise expectations that new antibiotics were unnecessary; we have since seen that bacteria can generate stable resistance to every antibiotic in rapid fashion, with no detrimental effects on their pathogenicity.
Kumarasamy KK、Toleman MA、Walsh TR 等人：在印度、巴基斯坦和英国出现新的抗生素耐药机制：一项分子、生物学和流行病学研究。《柳叶刀传染病》10(9)，597-602（2010）。细菌总是会比我们聪明吗？随着金属β-内酰胺酶 bla(NDM-1)基因的出现，情况似乎确实如此。曾经，细菌克隆只存在于医院或长期护理机构，但现在很明显，由于便捷、快速的全球旅行，它们有能力在社区中茁壮成长，并迅速在各国和各大洲传播，几乎没有任何障碍。因此，在有利于该生物体的条件下（滥用或不当使用抗生素和感染控制程序不佳），曾经是局部问题的情况可能会迅速演变成全球健康危机。鉴于一种新抗生素的发现和开发可能需要十年或更长时间，在一种成功的新型药物上市之前，耐药性病原体有足够的时间造成严重破坏。曾经，一种药物青霉素就足以让人产生新抗生素不必要的期望；此后，我们已经看到细菌可以迅速产生对每种抗生素的稳定耐药性，而对其致病性没有任何不利影响。
